Makokha Ernest P, Mwalili Samuel, Basiye Frank L, Zeh Clement, Emonyi Wilfred I, Langat Raphael, Luman Elizabeth T, Mwangi Jane
Division of Global HIV/AIDS, US Centers for Disease Control and Prevention, Kenya.
Academic Model Providing Access to Healthcare (AMPATH), Moi University School of Medicine, Kenya.
Afr J Lab Med. 2014 Nov 3;3(2):220. doi: 10.4102/ajlm.v3i2.220. eCollection 2014.
Kenya is home to several high-performing internationally-accredited research laboratories, whilst most public sector laboratories have historically lacked functioning quality management systems. In 2010, Kenya enrolled an initial eight regional and four national laboratories into the Strengthening Laboratory Management Toward Accreditation (SLMTA) programme. To address the challenge of a lack of mentors for the regional laboratories, three were paired, or 'twinned', with nearby accredited research laboratories to provide institutional mentorship, whilst the other five received standard mentorship.
This study examines results from the eight regional laboratories in the initial SLMTA group, with a focus on mentorship models.
Three SLMTA workshops were interspersed with three-month periods of improvement project implementation and mentorship. Progress was evaluated at baseline, mid-term, and exit using the Stepwise Laboratory Quality Improvement Process Towards Accreditation (SLIPTA) audit checklist and scores were converted into a zero- to five-star scale.
At baseline, the mean score for the eight laboratories was 32%; all laboratories were below the one-star level. At mid-term, all laboratories had measured improvements. However, the three twinned laboratories had increased an average of 32 percentage points and reached one to three stars; whilst the five non-twinned laboratories increased an average of 10 percentage points and remained at zero stars. At exit, twinned laboratories had increased an average 12 additional percentage points (44 total), reaching two to four stars; non-twinned laboratories increased an average of 28 additional percentage points (38 total), reaching one to three stars.
The partnership used by the twinning model holds promise for future collaborations between ministries of health and state-of-the-art research laboratories in their regions for laboratory quality improvement. Where they exist, such laboratories may be valuable resources to be used judiciously so as to accelerate sustainable quality improvement initiated through SLMTA.
肯尼亚拥有多个国际认可的高绩效研究实验室,而大多数公共部门实验室历来缺乏有效的质量管理体系。2010年,肯尼亚最初将八个区域实验室和四个国家实验室纳入加强实验室管理以实现认可(SLMTA)计划。为应对区域实验室缺乏导师的挑战,其中三个实验室与附近的认可研究实验室配对,即“结对”,以提供机构指导,而其他五个实验室接受标准指导。
本研究考察了最初参与SLMTA计划的八个区域实验室的结果,重点关注指导模式。
三个SLMTA研讨会与为期三个月的改进项目实施和指导阶段穿插进行。在基线、中期和结束时,使用迈向认可的逐步实验室质量改进过程(SLIPTA)审核清单对进展进行评估,并将分数转换为从零到五星级的等级。
在基线时,八个实验室的平均分数为32%;所有实验室均低于一星级水平。在中期,所有实验室都有测量到的改进。然而,三个结对实验室平均提高了32个百分点,达到一至三星级;而五个未结对实验室平均提高了10个百分点,仍为零星级。在结束时,结对实验室平均又提高了12个百分点(总计44个百分点),达到二至四星级;未结对实验室平均又提高了28个百分点(总计38个百分点),达到一至三星级。
结对模式所采用的伙伴关系有望在未来促进卫生部与所在地区的先进研究实验室之间为提高实验室质量而开展合作。如果存在这样的实验室,它们可能是宝贵的资源,应明智地加以利用,以加速通过SLMTA启动的可持续质量改进。